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Question 1

What are the environmental agents that cause cause?

Answer 1

• lonizing radiation- Well established that exposure to ionizing radiation increases risk of haematological malignancies (Hiroshima and Nagasaki
• Those working with risk of radiation exposure- have stringent safety procedures and health checks
• Common types of leukaemia associated with atomic bomb- acute leukaemias and chronic myeloid leukaemia, myelodysplastic syndromes (MDS)
• Research and data has revealed the closer the survivor was to detonation greater risk

Question 2

What are Haematological malignancies described as?

Answer 2

Dysregulation of Haemopiesis

Question 3

Dysregulaton of Haemopiesis results in?

Answer 3

Failure to produce effector cells (Neutrophils, RBS, etc)
Accumalation of cells at a particular intermediate maturation stage knowns as ‘Maturational Arrest’
Increased cellular proliferation rate
Failure of apoptosis

Question 4

What are the symptoms of Acute Lymphoblastic Leukaemia?

Answer 4

Fatigue
Paleness
Shortness of breath
Easy bruising and bleeding
Frequent infections
Pain in the bones or joints
Swollen lymph nodes
Unexplaned weight loss
Fever

Question 5

What are the infectious agents that cause cancer?

Answer 5

• Epstien Barr virus (EBV)- It does not mean anybody exposed to EBV will develop cancer later- first virus to be associated with human tumour (Burkitt Lymphoma)
• Human T-Lymphotrophic virus-1 (HTLV-1)- associated with adult T-cell leukaemia
(ATL)- found in Africa, Caribbean and Japan- mechanism of transformation is complex, thought to involve inactivation of TSG, cell cycle regulators and anti-apoptotic proteins

Benzene and leukaemia

• Link between aromatic and polycyclic hydrocarbons and cancer well established
Benzene well established leukaemogen
• AML has strongest link
• CLL weaker link
People in the petrochemical, shoe, rubber and paint industries high risk of benzene exposure

Cytogenetics

• Analysis of wbc chromosomes has revealed a lot about the biology of blood
cancers and also very useful as a diagnostic tool.
• So much so that specific chromosomal aberrations are used as specific means of
classifying certain leukaemias